{"title":"埃塞俄比亚东部哈拉里地区和迪勒达瓦市政府公立医院产妇并发症成本及其相关因素:一项基于机构的横断面研究。","authors":"Samrawit Shawel, Behailu Hawulte Ayele, Yadeta Dessie, Abera Kenay Tura, Gimaye Dinsa, Abainash Tekola, Miheret Mandefro, Awoke Masrie, Aklilu Tamire, Obsan Kassa Tefasa","doi":"10.2147/CEOR.S416562","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Pregnant women face high costs for health-care services despite being advertised as free. These costs include non-medical expenses, lost productivity, difficulties caring for family members, and long-term financial impact from complications. Limited research has been done on the cost burden of maternal services and complications, despite numerous studies on maternal health service provision. This is notable considering the government's claim of providing free maternal health-care services.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in July (1-30) 2022 among 425 randomly selected mothers in Harari and Dire Dawa City, Eastern Ethiopia. Data were collected through structured questionnaires and medical record reviews. The collected data was entered into Epi-Data version 3.02 and analyzed using STATA version 14.0 after data cleaning. Descriptive statistics and linear regression analysis were used to examine the data, ensuring assumptions of linearity, independence, homoscedasticity, and normality were met. The correlation coefficient was used to assess the strength of the association.</p><p><strong>Results: </strong>The median cost of maternal complications was around 4250 ETB (81.3 USD; IQR = 2900-5833.3), factors that predicted cost were monthly family income of ≥3001 birr (β=1.13; 95% CI: 1.00, 1.26), distance from hospital (β=0.73; 95% CI = 0.64-0.83), being admitted for less than 4 days (β=0.60; 95% CI = 0.53-0.69), accompanied by relatives besides their husbands (β=1.93; 95% CI = 1.52-2.46), caesarian sections delivery (β=1.17; 95% CI = 1.04-1.31), and giving birth to a normal baby (β=0.86; 95% CI = 0.77-0.97).</p><p><strong>Conclusion: </strong>Maternal complications incur significant costs, with factors such as family income, travel time, hospital stay, caregiver presence, mode of delivery, and neonatal outcome predicting these costs. The Ethiopian health system should address the additional expenses faced by mothers with complications and their caregivers.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/01/85/ceor-15-645.PMC10494998.pdf","citationCount":"0","resultStr":"{\"title\":\"The Cost of Maternal Complications and Its Associated Factors Among Mothers Attending Public Hospitals in Harari Region and Dire Dawa City Administration, Eastern Ethiopia: An Institution-Based Cross-Sectional Study.\",\"authors\":\"Samrawit Shawel, Behailu Hawulte Ayele, Yadeta Dessie, Abera Kenay Tura, Gimaye Dinsa, Abainash Tekola, Miheret Mandefro, Awoke Masrie, Aklilu Tamire, Obsan Kassa Tefasa\",\"doi\":\"10.2147/CEOR.S416562\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Pregnant women face high costs for health-care services despite being advertised as free. These costs include non-medical expenses, lost productivity, difficulties caring for family members, and long-term financial impact from complications. Limited research has been done on the cost burden of maternal services and complications, despite numerous studies on maternal health service provision. This is notable considering the government's claim of providing free maternal health-care services.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in July (1-30) 2022 among 425 randomly selected mothers in Harari and Dire Dawa City, Eastern Ethiopia. Data were collected through structured questionnaires and medical record reviews. The collected data was entered into Epi-Data version 3.02 and analyzed using STATA version 14.0 after data cleaning. Descriptive statistics and linear regression analysis were used to examine the data, ensuring assumptions of linearity, independence, homoscedasticity, and normality were met. The correlation coefficient was used to assess the strength of the association.</p><p><strong>Results: </strong>The median cost of maternal complications was around 4250 ETB (81.3 USD; IQR = 2900-5833.3), factors that predicted cost were monthly family income of ≥3001 birr (β=1.13; 95% CI: 1.00, 1.26), distance from hospital (β=0.73; 95% CI = 0.64-0.83), being admitted for less than 4 days (β=0.60; 95% CI = 0.53-0.69), accompanied by relatives besides their husbands (β=1.93; 95% CI = 1.52-2.46), caesarian sections delivery (β=1.17; 95% CI = 1.04-1.31), and giving birth to a normal baby (β=0.86; 95% CI = 0.77-0.97).</p><p><strong>Conclusion: </strong>Maternal complications incur significant costs, with factors such as family income, travel time, hospital stay, caregiver presence, mode of delivery, and neonatal outcome predicting these costs. The Ethiopian health system should address the additional expenses faced by mothers with complications and their caregivers.</p>\",\"PeriodicalId\":47313,\"journal\":{\"name\":\"ClinicoEconomics and Outcomes Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/01/85/ceor-15-645.PMC10494998.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ClinicoEconomics and Outcomes Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2147/CEOR.S416562\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ClinicoEconomics and Outcomes Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/CEOR.S416562","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
摘要
背景:尽管宣传的保健服务是免费的，但孕妇面临高昂的保健费用。这些费用包括非医疗费用、生产力损失、照顾家庭成员的困难以及并发症造成的长期财务影响。尽管对孕产妇保健服务的提供进行了大量研究，但对孕产妇服务的成本负担和并发症的研究有限。考虑到政府声称提供免费产妇保健服务，这一点值得注意。方法:于2022年7月1日至30日在埃塞俄比亚东部哈拉里和迪勒达瓦市随机选择425名母亲进行横断面研究。通过结构化问卷调查和医疗记录审查收集数据。收集的数据输入Epi-Data 3.02版本，数据清洗后使用STATA 14.0版本进行分析。采用描述性统计和线性回归分析对数据进行检验，确保满足线性、独立性、均方差和正态性假设。使用相关系数来评估关联的强度。结果:产妇并发症的中位成本约为4250 ETB(81.3美元);IQR = 2900-5833.3)，预测成本的因素为家庭月收入≥3001 birr (β=1.13;95% CI: 1.00, 1.26)，离医院的距离(β=0.73;95% CI = 0.64-0.83)，住院时间少于4天(β=0.60;95% CI = 0.53-0.69)，除丈夫外有亲属陪同(β=1.93;95% CI = 1.52-2.46)，剖宫产(β=1.17;95% CI = 1.04-1.31)，生育正常婴儿(β=0.86;95% ci = 0.77-0.97)。结论:产妇并发症会产生巨大的成本，家庭收入、出行时间、住院时间、护理人员在场、分娩方式和新生儿结局等因素可预测这些成本。埃塞俄比亚卫生系统应解决患有并发症的母亲及其护理人员面临的额外费用问题。
The Cost of Maternal Complications and Its Associated Factors Among Mothers Attending Public Hospitals in Harari Region and Dire Dawa City Administration, Eastern Ethiopia: An Institution-Based Cross-Sectional Study.
Background: Pregnant women face high costs for health-care services despite being advertised as free. These costs include non-medical expenses, lost productivity, difficulties caring for family members, and long-term financial impact from complications. Limited research has been done on the cost burden of maternal services and complications, despite numerous studies on maternal health service provision. This is notable considering the government's claim of providing free maternal health-care services.
Methods: A cross-sectional study was conducted in July (1-30) 2022 among 425 randomly selected mothers in Harari and Dire Dawa City, Eastern Ethiopia. Data were collected through structured questionnaires and medical record reviews. The collected data was entered into Epi-Data version 3.02 and analyzed using STATA version 14.0 after data cleaning. Descriptive statistics and linear regression analysis were used to examine the data, ensuring assumptions of linearity, independence, homoscedasticity, and normality were met. The correlation coefficient was used to assess the strength of the association.
Results: The median cost of maternal complications was around 4250 ETB (81.3 USD; IQR = 2900-5833.3), factors that predicted cost were monthly family income of ≥3001 birr (β=1.13; 95% CI: 1.00, 1.26), distance from hospital (β=0.73; 95% CI = 0.64-0.83), being admitted for less than 4 days (β=0.60; 95% CI = 0.53-0.69), accompanied by relatives besides their husbands (β=1.93; 95% CI = 1.52-2.46), caesarian sections delivery (β=1.17; 95% CI = 1.04-1.31), and giving birth to a normal baby (β=0.86; 95% CI = 0.77-0.97).
Conclusion: Maternal complications incur significant costs, with factors such as family income, travel time, hospital stay, caregiver presence, mode of delivery, and neonatal outcome predicting these costs. The Ethiopian health system should address the additional expenses faced by mothers with complications and their caregivers.
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